Benzodiazepines are effective in reducing panic attacks and phobic behavior, as well as the anticipatory phase of panic attacks. Drugs in this class include clonazepam (Klonopin) , lorazepam (Ativan) , and alprazolam (Xanax) . While benzodiazepines act quickly, are effective, and are medically safe, approximately one half of patients experience withdrawal symptoms when removed from the medication and many clinicians believe that patients receiving them may develop a tolerance to the drug. Benzodiazepines may also increase falls, and cause confusion and memory problems in the elderly.
Of the antidepressants, the tricyclic antidepressant, imipramine (Tofranil), has been the most extensively investigated and is considered by some a standard treatment for anxiety. Other cyclic drugs that have been found to be effective in treating panic disorder include Pamelor (nortryptyline), Norpramin (desipramine), and Anafranil (clomipramine). Tricyclics, unlike benzodiazepines, require only a single daily dose of medication. They are well studied and also help to guard against depression, which is often comorbid with panic disorder.
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